Al-Omran A, Al-Abdi S, Al-Salam Z
Department of Pediatrics, Almana General Hospital, Al-Ahsa, Saudi Arabia.
Department of Pediatrics, King Abdulaziz Hospital, Ministry of National Guard Hospital, Al-Ahsa, Saudi Arabia.
J Neonatal Perinatal Med. 2017;10(2):181-189. doi: 10.3233/NPM-171696.
Hyperbilirubinemia is one of the most common causes of neonatal readmission to hospital.
To assess risk factors for hyperbilirubinemia among neonates readmitted for this condition and the ratio of the mean corpuscular hemoglobin concentration (MCHC) to the mean corpuscular volume (MCV).
We retrospectively studied the clinical and laboratory findings, management and possible risk factors for hyperbilirubinemia in 301 neonates born at ≥35 weeks gestation and readmitted to hospital owing to hyperbilirubinemia over five years.
No risk factors for hyperbilirubinemia were identified in 64 (21.3%) neonates, and one or more risk factors were found in 237 neonates (78.7%). The most prevalent risk factor (41.9%) was G6PD deficiency, which occurred in 11 of the 15 neonates with a serum bilirubin level ≥427 μmol/l. A double-volume exchange blood transfusion was performed in two neonate boys in whom G6PD deficiency was the single risk factor for hyperbilirubinemia. One of them developed kernicterus later. The MCHC/MCV ratio of neonates with idiopathic hyperbilirubinemia, unexplained hemolysis, or other risk factors overlapped.
This study confirmed that in an area where G6PD deficiency is prevalent, it is the most common and most severe risk factor for hyperbilirubinemia. This finding supports routine neonatal screening for G6PD deficiency in such areas. The usefulness of determining the MCHC/MCV ratio in the management of hyperbilirubinemia is uncertain.
高胆红素血症是新生儿再次入院最常见的原因之一。
评估因该病症再次入院的新生儿中高胆红素血症的危险因素以及平均红细胞血红蛋白浓度（MCHC）与平均红细胞体积（MCV）的比值。
我们回顾性研究了301例孕龄≥35周、因高胆红素血症在5年内再次入院的新生儿的临床和实验室检查结果、治疗情况及高胆红素血症可能的危险因素。
64例（21.3%）新生儿未发现高胆红素血症的危险因素，237例（78.7%）新生儿发现一个或多个危险因素。最常见的危险因素（41.9%）是葡萄糖-6-磷酸脱氢酶（G6PD）缺乏，在15例血清胆红素水平≥427μmol/L的新生儿中有11例出现。两名G6PD缺乏是高胆红素血症唯一危险因素的男婴接受了双倍量换血治疗。其中一人后来发生了核黄疸。特发性高胆红素血症、不明原因溶血或其他危险因素的新生儿的MCHC/MCV比值重叠。
本研究证实，在G6PD缺乏流行的地区，它是高胆红素血症最常见和最严重的危险因素。这一发现支持在此类地区对新生儿进行常规G6PD缺乏筛查。在高胆红素血症治疗中测定MCHC/MCV比值的有用性尚不确定。
